Comprehensive Medical Aid Plan – 2021 Comparisons
Comprehensive Medical Aid Plan: Offers unlimited hospital cover and Comprehensive Medical Aid Plan benefits. In new generation plans, initial claims will be funded from a medical savings account. Thereafter when all accumulated day-to-day claims reach a specified threshold, another risk benefit kicks in and continues to pay claims until the end of the year.
Traditional options have generous amounts of day-to-day cover for all the different medical providers except for GP’s consultations and conservative dentistry where cover is generally unlimited and no benefits carry forward to the next year.
View our latest 2021 plan updates below.
5 Comprehensive Plans Compared2021 Comparisons Made Easy!
| DISCOVERY | |||
| CLASSIC COMPREHENSIVE - Comprehensive Plan | |||
| MONTHLY CONTRIBUTIONS | |||
| Principal Member | R 5,954 | ||
| Spouse/Adult Dependant | R 5,633 | ||
| Per Child (Max 3) | R 1,188 | ||
| IN HOSPITAL BENEFIT | |||
| 2021 BENEFITS | |||
| 200% Scheme Rate | |||
| No Overall Annual Limit | |||
| Network Hospitals to be used. | |||
| Certain procedure only covered at Network Day Clinics. | |||
| Annual Sub-limits per person: | |||
| Psychiatric Treatment | 21 days | ||
| Compassionate Care | R 71,150 | ||
| Oncology R 400 000 thereafter 20% co-payment. | |||
| Specialised Medicine & Technology | R 200,000 | ||
| Internal Prostheses: See detailed benefit schedule. | |||
| CHRONIC MEDICATION | |||
| 100% Scheme Rate | |||
| 27 PMB Chronic Disease Conditions. | |||
| Subject to scheme formulary. | |||
| (Additional 23 Chronic Disease Conditions) | |||
| ANNUAL DAY TO DAY BENEFIT | |||
| (including Savings) | |||
| 100% Scheme Rate | |||
| Limits per annum: | |||
| Member | R 17,856 | ||
| Member + Spouse | R 34,752 | ||
| Member + Spouse + Child 1 | R 38,316 | ||
| Member + Spouse + Child 2 | R 41,880 | ||
| Member + Spouse + Child 3 | R 45,444 | ||
| Member + Child 1 | R 21,420 | ||
| Member + Child 2 | R 24,984 | ||
| Member + Child 3 | R 28,548 | ||
| Day-to-day Extender Benefit | |||
| ANNUAL THRESHOLD | |||
| Principal Member | R 21,700 | ||
| Spouse/Adult Dependant | R 21,700 | ||
| Per Child | R 4,150 | ||
| DISCOVERY | |||
| CLASSIC DELTA COMPREHENSIVE - Comprehensive Plan | |||
| MONTHLY CONTRIBUTIONS | |||
| Principal Member | R 5,362 | ||
| Spouse/Adult Dependant | R 5,077 | ||
| Per Child (Max 3) | R 1,069 | ||
| IN HOSPITAL BENEFIT | |||
| 2021 BENEFITS | |||
| 200% Scheme Rate | |||
| No Overall Annual Limit | |||
| Network Hospitals to be used. | |||
| Certain procedure only covered at Network Day Clinics. | |||
| Annual Sub-limits per person: | |||
| Psychiatric Treatment | 21 days | ||
| Compassionate Care | R 71,150 | ||
| Oncology R 400 000 thereafter 20% co-payment. | |||
| Specialised Medicine & Technology | R 200,000 | ||
| Internal Prostheses: See detailed benefit schedule. | |||
| CHRONIC MEDICATION | |||
| 100% Scheme Rate | |||
| 27 PMB Chronic Disease Conditions. | |||
| Subject to scheme formulary. | |||
| (Additional 23 Chronic Disease Conditions) | |||
| ANNUAL DAY TO DAY BENEFIT | |||
| (including Savings) | |||
| 100% Scheme Rate | |||
| Limits per annum: | |||
| Member | R 16,080 | ||
| Member + Spouse | R 31,308 | ||
| Member + Spouse + Child 1 | R 34,512 | ||
| Member + Spouse + Child 2 | R 37,716 | ||
| Member + Spouse + Child 3 | R 40,920 | ||
| Member + Child 1 | R 19,284 | ||
| Member + Child 2 | R 22,488 | ||
| Member + Child 3 | R 25,692 | ||
| Day-to-day Extender Benefit | |||
| ANNUAL THRESHOLD | |||
| Principal Member | R 21,700 | ||
| Spouse/Adult Dependant | R 21,700 | ||
| Per Child | R 4,150 | ||
| DISCOVERY | ||
| CLASSIC PRIORITY - Comprehensive Plan | ||
| MONTHLY CONTRIBUTIONS | ||
| Principal Member | R 3,814 | |
| Spouse/Adult Dependant | R 3,008 | |
| Per Child (Max 3) | R 1,526 | |
| IN HOSPITAL BENEFIT | ||
| 2021 BENEFITS | ||
| 200% Scheme Rate | ||
| No Overall Annual Limit | ||
| Network Hospitals to be used. | ||
| Annual Sub-limits per person: | ||
| Psychiatric Treatment | 21 days | |
| Compassionate Care | R 71,150 | |
| Oncology R 200 000 thereafter 20% co-payment. | ||
| Internal Prostheses: See detailed benefit schedule. | ||
| CHRONIC MEDICATION | ||
| 100% Scheme Rate | ||
| 27 PMB Chronic Disease Conditions. | ||
| Subject to scheme formulary. | ||
| ANNUAL DAY TO DAY BENEFIT | ||
| (including Savings) | ||
| 100% Scheme Rate | ||
| Limits per annum: | ||
| Member | R 11,436 | |
| Member + Spouse | R 20,460 | |
| Member + Spouse + Child 1 | R 25,032 | |
| Member + Spouse + Child 2 | R 29,604 | |
| Member + Spouse + Child 3 | R 34,176 | |
| Member + Child 1 | R 16,008 | |
| Member + Child 2 | R 20,580 | |
| Member + Child 3 | R 25,152 | |
| Day-to-day Extender Benefit | ||
| ANNUAL THRESHOLD | ||
| Principal Member | R 17,550 | |
| Spouse/Adult Dependant | R 13,200 | |
| Per Child | R 5,850 | |
| FEDHEALTH | ||
| FLEXIFED 4 ANY - Hospital Plan/Day to Day Cover | ||
| MONTHLY CONTRIBUTIONS | ||
| Principal Member | R 3,747 | |
| Spouse/Adult Dependant | R 3,399 | |
| Per Child (Max 3) | R 1,153 | |
| IN HOSPITAL BENEFIT | ||
| 2021 BENEFITS | ||
| 100% Scheme Rate | ||
| No Overall Annual Limit | ||
| Co-payments are due for certain procedures | ||
| (eg: R2 600 for Arthroscopy) | ||
| *30 days Post Hospital Cover | ||
| *7 days Take Home Medicine | ||
| *Emergency Trauma at Out Patients | ||
| Psychiatric Treatment | R 2,700 | |
| Hospice Care | R 33,300 | |
| Oncology (only at DSP) | R 480,400 | |
| Internal Prosthesis | R 26,900 | |
| CHRONIC MEDICATION | ||
| 100% Scheme Rate | ||
| 43 Chronic Disease Conditions. | ||
| Subject to Intermediate Scheme formulary. | ||
| Only from Medi-Rite, Clicks, Dis-Chem & | ||
| Pharmacy Direct. | ||
| ANNUAL DAY TO DAY BENEFIT | ||
| (including Savings) | ||
| 100% Scheme Rate | ||
| Member | R 324 | |
| Spouse | R 288 | |
| Per Child (Max 3) | R 96 | |
| MediVault Savings amounts are not pro-rated and can be | ||
| transferred to your Wallet at any time and paid back | ||
| interest-free over a period of 12 months: | ||
| Total Annual Day-to-day Limits: | ||
| Member | R 15,024 | |
| Member + 1 | R 27,312 | |
| Member + 2 | R 31,008 | |
| Member + 2 + | R 34,704 | |
| Unlimited Network GP Benefit | ||
| ANNUAL THRESHOLD | ||
| Member | R 14,700 | |
| Member + 1 | R 26,700 | |
| Member + 2 | R 30,300 | |
| Member + 2 + | R 33,900 | |
| FEDHEALTH | ||
| MAXIMA EXEC - Comprehensive Plan | ||
| MONTHLY CONTRIBUTIONS | ||
| Principal Member | R 6,816 | |
| Spouse/Adult Dependant | R 5,917 | |
| Per Child (Max 3) | R 2,168 | |
| IN HOSPITAL BENEFIT | ||
| 2021 BENEFITS | ||
| 200% Scheme Rate | ||
| No Overall Annual Limit | ||
| Co-payments are due for certain procedures | ||
| (eg: R2 600 for Arthroscopy) | ||
| *30 days Post Hospital Cover | ||
| *7 days Take Home Medicine | ||
| *Emergency Trauma at Out Patients | ||
| Psychiatric Treatment | R 34,500 | |
| Hospice Care | R 33,300 | |
| Oncology (only at DSP) | R 600,600 | |
| Internal Prosthesis | R 31,500 | |
| CHRONIC MEDICATION | ||
| 100% Scheme Rate | ||
| 51 Chronic Disease Conditions. | ||
| Subject to Intermediate Scheme formulary. | ||
| Only from Medi-Rite, Clicks, Dis-Chem & Pharmacy Direct | ||
| Single | R 7,600 | |
| Per Family | R 14,000 | |
| ANNUAL DAY TO DAY BENEFIT | ||
| (including Savings) | ||
| 100% Scheme Rate | ||
| Limites per annum: | ||
| Member | R 10,560 | |
| Member + Spouse | R 19,728 | |
| Member + Spouse + Child 1 | R 23,076 | |
| Member + Spouse + Child 2 | R 26,424 | |
| Member + Spouse + Child 3 | R 29,772 | |
| Member + Child 1 | R 13,908 | |
| Member + Child 2 | R 17,256 | |
| Member + Child 3 | R 20,604 | |
| Unlimited Network GP Benefit | ||
| ANNUAL THRESHOLD | ||
| Principal Member | R 14,800 | |
| Spouse/Adult Dependant | R 11,400 | |
| Per Child (max 3) | R 3,800 | |
As additional Comprehensive Medical Aid Plan comparisons are made available we will continue to update this page in our effort to provide our clients with the most up to date information and advice on the medical aid industry in South Africa. If you are still deciding which plan type is best suited to your situation, why not take a look at the Medical Aid Plans page to see the full range of plans.
For more detailed information on any of the above Comprehensive Medical Aid Plan comparisons simply contact us. If you already know what you want, why not make use of our site to download the relevant Medical Aid Application form and then fax it back to us on 0866 200 320 . Alternatively, if you would like us to confirm some of the finer details and pricing just fill in our free Medical Aid Quote Request form and we will get back to you promptly.
Finally, we invite you to contact us on +27 21 712 8866 at any point in your decision making process for further information on these Comprhensive Medical Aid Plan comparisons.
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